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Individual

JEANEAN D SMALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
55 SHIAWASSEE AVE STE 10G, FAIRLAWN, OH 44333-3700
(330) 286-4011
(330) 286-4011
Mailing address
55 SHIAWASSEE AVE STE 10G, FAIRLAWN, OH 44333-3700
(330) 286-4011
(330) 286-4011

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.410483
OH
363LF0000X
Family Nurse Practitioner
Primary
0030067
OH

Other

Enumeration date
12/31/2018
Last updated
09/11/2022
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